PERIURETHRAL AUTOLOGOUSFAT INJECTION IN THE TREATMENT OF FEMALE STRESS URINARY INCONTINENCE

The need for an easily available and cost-effective treatment for stress urinary incontinence (SUI) of women in the developing communities is a challenging issue for the urologist. We have attempted to determine the efficacy of periurethral autologous- fat injection in the treatment of female stress urinary incontinence (SUI). from October199 5to December 1998a total of 22 women, 10 with Type III SUI and 12 with Type I SUI underwent periurethral autologous fat injection. Pre-operative and follow-up evaluations consisted of filling out appropriate questionnaires, vaginal examination, stress test, subjective incontinence scoring, subjective estimation of the quantity of urinary leakage and urodynamic determination of abdominal leak point pressure (ALPP). Fifteen to 35 ml of fat was harvested from the anterior abdominal wall by liposuction and injected periurethrally under direct cystoscopic vision. Injection was done once in 20 patients and 2 patients received two injections. Follow-up period ranged from 13 to 50 months (mean 31 months). Out of 10 patients with Type III SUI, 4 (40%) were cured, 4 (40%) improved and 2 (20%) incurred failure, giving a total success rate of 80%. Out of 12 patients with Type I SUI only 1 (8.3%) was cured, 5 (41.7%) noticed improvement and 6 (50%) failed. The overall success rate in this group was 50%. The total success rate in the 22 women was 63.6 %. There were no major complications. Autologous fat can be a safe and cost-effective material for injection therapy of SUI. It was shown to be an effective alternative method in the treatment of Type III SUI in female, our results in Type I SUI were, however, disappointing.